Q&A with Mary Brainerd: A Patient’s Perspective

How does a philosophy major find herself leading a large health care organization?There is no doubt in my mind that an undergraduate liberal arts background is an asset in my job. A broad background, learning and building understanding from many perspectives is an excellent foundation for leadership.

Many people have a love-hate relationship with health care. They depend on the services, but often complain about the experience. We all know we’re not yet getting what we need: better care, better health, longer lives and a lower price tag. In fact, prices in the United States are 30 percent higher than anywhere else in world.

How can you change that dynamic?At HealthPartners, we are impatient with the status quo. We don’t want to defend the system. We want to change it. Dramatically.We have whole teams of people redesigning care and the way care is delivered. We began by changing from paper to electronic medical records. We’re also changing where care is delivered: not only in clinics but also in the workplace, in Minute Clinics, online and over the phone. We are offering online support and proactive care that reaches out to you instead of waiting for you to call for an appointment. We need innovative support systems that we cannot even imagine in the current delivery system. That’s what it will take to meet the very individual needs andexpectations of patients.

You were diagnosed with breast cancer seven years ago. How did your care and treatment change your perspective on health care?I think I have a very strong understanding and empathy for the needs of patients and their families. And I highly value the importance of caring and compassion in our work.

How have you tried to encourage that same perspective at HealthPartners?We have a strong focus on the experience of our patients and members. In fact, we have established advisory Patient Councils to give us guidance on everything from building design to effective end-of-life discussions.

Minnesota is often thought of as an innovator in the health care industry. What are we doing well right now? We are a leader in collaboration to improve health care results. The Institute for Clinical Systems Improvement is one example. HealthPartners is a co-founder of ICSI, which represents 7,600 physicians in medical groups and hospitals working together to improve the quality of care in our state. Another example is MN Community Measurement, in which health plans and medical groups cooperatively share information on health care quality to improve results and share information about results so that consumers can choose medical groups that do the best job of caring forpatients with conditions such as diabetes or asthma. This collaboration improves quality of care. Minnesota’s quality of care is among the best in the nation for prevention, diabetes, asthma, smoking cessation and other conditions. It is no coincidence that Minnesota is also the healthiest state in the nation.

Despite the success stories in our state, we’ve seen an 80 percent increase between 2001 and 2004 in the number of uninsured children under the age of six. What is the cause of this increase?While Minnesota has the lowest uninsured rate in the country, higher health care costs, changes in eligibility for government-sponsored programs, an increase in the percentage of children with family incomes below federal poverty guidelines and a reduction in employer-offered coverage all play a role in the increasing numbers of uninsured children. A more staggering statistic is the fact thatalmost 60 percent of uninsured Minnesotans, children and adults, are eligible for an existing program, but are often unaware of that fact, or unsure about how to enroll.

Health care expenses continue to rise. What needs to happen to bring these costs under control?We need to improve health and we need to improve the quality of health care. We are working with employers, schools and lawmakers to improve health by providing incentives to increase activity, get preventive screening, improve nutrition and stop smoking. We are working to improve quality by establishing best practice guidelines to deliver the best care based on the latest medical evidence.We must continue to measure how providers do, publicly report it and reward providers who deliver the best care for patients.Providing health care coverage to every citizen will also result in more efficient use of health care resources because patients will get the care they need when they need it and not just when it is an emergency – which can be the most expensive kind of care.

What technological changes will have the greatest impact on health care in the near term?Treatments and medications will be engineered to meet the specific genetic traits of individual patients. This change will individualize care in ways that will revolutionize health care.

HealthPartners Research Foundation is one of the largest research foundations in the country, funding more than 250 projects annually. Is there one particular project that has captured your attention?One project that captured a lot of attention was Dr. Brian Martinson’s study on research integrity. The 2005 study revealed that a wide range of questionable research behaviors are threatening scientific integrity. It was widely covered by national and international media and was quite controversial among scientific researchers who were forced to take a hard and realistic look at how they conductresearch. I found this study compelling because it promotes accountability and ethical practices in the research industry.

In 2006, HealthPartners was named a “Great Place to Work” by the Minneapolis/St. Paul Business Journal. What do your employees appreciate most about working at HealthPartners?We asked our employees that exact question after winning the award. Overwhelmingly, our employees responded that they appreciate being on a team with great people who are passionate about improving the health of our community. We know that teamwork and partnership are essential to achieving our mission. In fact we like to say, “Health is what we do. Partnership is how we do it.” It’s inspiring to work with such committed, passionate people.

Balancing work with family and health is a priority for you. Are you able to find time to live by example?It is easier now with our children in college. I have always found balance to be a challenge and have worked hard to keep my priorities straight – and family tops the list.

Dream big: If there were no obstacles, what one thing would you change about the health care industry?I would change the way we pay for health care so we would quit paying for volume or “production.” It’s time to take our doctors and nurses off the production line and instead reward effective chronic illness management and prevention in our payment systems.